Dr. Doug Naysmith (Bristol, North-West): Is the hon. Gentleman aware that there are Labour Members present with experience of serving on CHCs? I have served on two, including one in his constituency. Perhaps he could explain why the Organisation of South-West Community Health Councils, including the one that serves his area, has chosen not to oppose the proposals and instead agreed to work with the Government to introduce more effective measures?

11 am

Dr. Fox: Individual CHCs are answerable for their views. I hope that the hon. Gentleman is not trying to take a specific example and extrapolate it to the general, because it is clear that the vast majority of CHCs are against abolition. Is the hon. Gentleman suggesting that that example is typical of the attitude of CHCs?

Dr. Naysmith: The 14 CHCs in the south-west do not oppose the Bill.

Dr. Fox: That does not alter the point; the hon. Gentleman is well aware that that is not the view of the vast majority of CHCs or of the association, all of whom are against

Dr. Fox: Before I give way to the hon. Member for West Bromwich, West (Mr. Bailey), I shall finish what I was saying about the misrepresentation of support for CHCs. The Secretary of State went to great lengths to say that the College of Health supported his proposals. However, the college also stated:

``The College of Health regrets the lack of discussion with public and patient groups prior to the decision to abolish Community Health Councils announced in the NHS Plan. CHCs have important statutory rights and duties to represent the views and needs of their local populations and to be consulted on proposed changes in the provision of care by health authorities and trusts. We are concerned that under the new arrangements proposed, these important statutory rights should be strengthened and not weakened to the detriment of patient and public empowerment.

While welcoming the introduction of Patient Advocacy and Liaison Services (PALS) to trusts and acknowledging the important role they should have in helping patients sort out problems before they become complaints, we have strong reservations about the extent to which they will be seen as truly independent by patients who have a complaint about the trust, if the trusts employ and direct the work of the advocates. We are also concerned that PALS based in hospitals may be badly placed to help the majority of patients whose problems are to do with community or primary health care or with failure to access the services they need or relate to lack of co-ordination between primary and secondary and with social services.''

The other main concern expressed by the College of Health was that abolishing CHCs would risk fragmentation at local level.

Mr. Bailey: Will the hon. Gentleman give way?

Dr. Fox: I have said that I would give way; the hon. Gentleman must contain himself.

The college's other main concern was:

``we risk fragmentation at local level and, importantly, the loss of a good mechanism for monitoring and identifying national trends and patterns in both good and bad practice through the sharing of local knowledge and experience.''

I quote those comments at length because the Secretary of State used the college's words in defence of his proposals.

Mr. Bailey: Will the hon. Gentleman give way?

Dr. Fox: I have made it clear that I will give way in a moment.

The Secretary of State prayed that organisation in support of his policy. That shows that there is no end to the Government's twisting of words to pretend that organisations that clearly have major doubts about the proposals are in favour. I look forward to the next fantasy.

Mr. Bailey: I am grateful to the hon. Gentleman for ultimately giving way. I wish to be associated with the comments made by my hon. Friend the Member for Bristol, North-West (Dr. Naysmith); I would have got in first, but his timing was better than mine. First, I declare a non-pecuniary interest in that my wife is a member of a community health council. I, too, served for seven years on a CHC. I ask the hon. Member for Woodspring (Dr. Fox) to withdraw the accusations that he made about the membership of the Committee.

Dr. Fox: I am confused by that intervention. I am not sure what the hon. Gentleman wants me to withdraw. Does he want me to withdraw the comment that CHCs provide different qualities of support, or does he disagree with the fact that CHCs are against the Government's proposals? Is he trying to pretend to the Committee that CHCs welcome their abolition? Will the hon. Gentleman clarify what offends him?

Mr. Bailey: The hon. Gentleman went on for such a long time that he has probably forgotten what he was saying when I first asked him to give way. He was making accusations about the management and staffing of the Committee.

Dr. Fox: When the hon. Gentleman has been here a while, he will understand that the staffing of the Committee is not the same as the membership of the Committee.

Dr. Naysmith: Will the hon. Gentleman give way?

Dr. Fox: There is no doubt that the hon. Member for West Bromwich, West will be rewarded, as naked ambition and toadying are now qualities much to be recommended in the Labour party. The function of scrutiny of legislation has been entirely abandoned by Labour. The concept that Members are here to hold the Executive to account and to question what is going on has been completely forgotten.

Dr. Naysmith: I sat through the whole debate on Second Reading.

Mr. Hammond: Why did the hon. Gentleman not speak, then?

Dr. Naysmith: I was not called to speak. Two or three other Labour Members sat through the whole debate and were not called.

Dr. Fox: I am sure that the hon. Gentleman is right, but that does not change my view that the majority of Labour Members who spoke in that debate, no doubt randomly chosen by the Speaker, were hugely against the Government's proposals.

The Chairman: Order. The membership of the Committee has nothing to do with the debate, so I would be grateful if hon. Members returned to the amendment.

Dr. Fox: I am grateful to get back to the debate on the amendment, as I look forward to the Minister's reply to my specific points. I raised the issue of membership only so that those who read the report of our proceedings understand that the Committee does not represent the views of many Labour Members.

Mr. Ian Stewart (Eccles): On a point of order, Mr. Maxton. Clearly, the hon. Member for Woodspring does not read the reports of our proceedings. The matter was dealt with at our first sitting. I raised a point of order about whether it was appropriate for the Opposition to second-guess what was in the minds of Ministers, or for them to suggest that qualification for serving on a Committee was related to attendance at a previous debate. The hon. Gentleman does not know why people could not be at a certain debate.

The Chairman: I have already ruled that the debate on membership of the Committee should now cease, so we should get on with debating the amendment.

Mr. Simon Burns (West Chelmsford): On a point of order, Mr. Maxton. Are we allowed to drink anything other than water?

The Chairman: Members of the Committee are not allowed to, I am afraid.

Mr. Burns: Further to that point of order, Mr. Maxton. What would you do if an hon. Member were drinking coffee?

Mr. Stewart: I was not.

The Chairman: I was not aware that someone was drinking coffee. If someone is, he should remove it.

Dr. Fox: If I may, I will return to the abolition of CHCs. I recognise that a raw nerve has been touched.

We have six tests to apply. There has been no consultation, and costing has not been carried out properly. The abolition will lead to fragmentation of services, loss of staff and increased costing, so is it workable? We do not sufficiently understand the accountability and independence of future mechanisms. The new proposals fail all such measures.

The group to be abolished has given sterling service to the NHS. Many people may become unemployed who have been extremely loyal to the task, for remuneration that has not been fantastic. The Government have failed to make the case for the changes, and have failed to consult about them in advance. We suspect that the changes are being made up as they go along, and that information is being given to those outside before it is given to the Committee.

The Minister has a great task, as he has to reassure the Committee, and through it those who pay attention to our deliberations, that the Government are not simply trying to gag the NHS and to ensure that patients are less able to get headlines that the Government hate into newspapers. We are losing a valuable resource, which even the Minister tells us works well in many parts of the country.

Our argument should be about raising standards to the best. Sadly, it has become about an entirely different Government agenda: one of putting the political process first and putting politics before patients.

Kali Mountford (Colne Valley): I did not intend to take too much of the Committee's time today, given that under the new programming rules time is of the essence and that the last speech was rather long, but I want to touch on a couple of the points raised. I do not recognise the picture of CHCs that has just been painted. I have had a quite different experience, and most Members will bring their own experiences. My experience of CHCs dates from when I was a councillor in Sheffield and the area health authority proposed to abolish one of the accident and emergency departments in the local hospitals. The proposal caused an outcry in the community and my own local authority opposed the proposal. I am sad to say that we felt that the CHC at that time did not serve the interests of the hospital patientswhich most concerns me. Of course the CHCs have a role in consultation, but surely patients too have a role, as do their feelings about the service that they receive.

Unfortunately, I have had two recent experiences of a CHC in my area. One arose from my own medical disaster, as a result of which I met other patients; the second concerns the proposed reconfiguration of hospital services. On the latter point, one would have expected the CHC to take a major role. The local community decided to develop something called ``Save our services'' because it felt that the CHC was not taking the expected lead role. The ``Save our services'' organisation was very successful and, as a result of its lobbying, quite a lot of changes were made to the original plans for the reconfiguration of the local hospital services. I am saying not that the CHC did nothing, but that it did not seem to be sufficiently well-equipped to deal with the problem that it faced. Many people were disappointed. Members of the ``Save our services'' organisation who were approached by the CHC, which said that it felt that its role was not being supported, telephoned me to say that they were very disappointed.